| Purpose Observational studies have demonstrated an association between Ribonucleotide reductase subunit M1 (RRM1) expression level and clinical outcomes in patients with advanced non-small cell lung cancer(NSCLC) treated with gemcitabine-based regimens.Through a meta-analysis of observational studies, we evaluated whether RRM1 expression levels are associated with the clinical outcome of gemcitabine-containing treatment regimen in patients with advanced non-small cell lung cancer (NSCLC).Methods A literature search was conducted using the PubMed, Embase, Web of Science, Wanfang and Chinese National Knowledge Infrastructure databases from inception to September 2014. Quality assessment was conducted in each of the available studies by using the validated Newcastle-Ottawa Quality Assessment Scale (NOS) for cohort and case-control studies. The odds ratio (OR) and its 95% confidence interval (95% CI) were employed to estimated effect size. All statistical analyses were carried out using RevMan 5.2 software.Results A total of 12 studies encompassing 593 NSCLC patients met our search criteria and were, therefore, included. Pooled analyses revealed that patients with low/negative RRM1 expression levels exhibited significantly higher response rates (OR:0.35,95% CI 0.24-0.51) and better survival rates (OR:0.41,95% CI 0.23-0.75) than those with high/positive RRM1 expression levels. Sub-group analyses did not reveal any significant difference in outcome regarding the RRM1 assessment methods used or the ethnicities of patient populations studied.Conclusions The meta-analysis reported here indicates that RRM1 expression is associated with the response rate and overall survival rate of advanced NSCLC patients treated with gemcitabine-based chemotherapy. The expression of RRM1 is related to the curative effect of gemcitabine and it can be a guidance for the clinical treatment. |
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